1 Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
2 Department of Radiology, Thomas Jefferson University, Philadelphia, PA.
AJR Am J Roentgenol. 2019 Apr;212(4):899-904. doi: 10.2214/AJR.18.20336. Epub 2019 Jan 30.
The purposes of this study were to document recent trends in stroke intervention at a tertiary-care facility with a comprehensive stroke center and to analyze current procedure volumes and the employment of specialty providers in neurointerventional radiology (NIR).
Institutional trends in the volume of mechanical thrombectomy were analyzed on the basis of the number of patients who underwent mechanical thrombectomy from 2013 to 2017. To evaluate the current status of mechanical thrombectomy volumes in the United States, the number of patients in the Medicare fee-for-service database who underwent mechanical thrombectomy in 2016 was assessed. The specialty backgrounds of the various providers who performed mechanical thrombectomy were analyzed. Procedure volumes for intracranial stenting, embolization, and vertebral augmentation procedures were assessed.
From 2013 to 2017, the total numbers of mechanical thrombectomy procedures for acute ischemic stroke were 19 in 2013 and 111 in 2017. The total volume of mechanical thrombectomy procedures in the Medicare fee-for-service population in 2016 was 7479. For intracranial endovascular procedures, 20,850 were performed in the U.S. Medicare population in 2015 and 22,511 in 2016. Radiologists performed 45% of procedures in 2016; neurosurgeons, 41%; and neurologists, 11%. When the total numbers of percutaneous brain and spine procedures were combined, radiologists performed 41%; neurosurgeons, 23%; and neurologists, 3%. In 2016, there were a total of 220 active NIR staff at the NIR programs with rotating residents or fellows. In these programs, 49% of staff members were neuroradiologists, 41% were neurosurgeons, and 10% were neurologists. Of the 72 NIR departments with confirmed rotating fellows or residents, 14 had only neuroradiologists on staff, six had only neurosurgeons, and one had only neurologists.
Increasing radiology resident interest and participation in NIR should ensure a steady influx of radiologists into the field, continuing the strong tradition of radiology participation, leadership, and innovation in NIR.
本研究旨在记录一家具有综合卒中中心的三级保健机构的卒中介入治疗的最新趋势，并分析当前的手术量以及神经介入放射学（NIR）专业人员的就业情况。
根据 2013 年至 2017 年接受机械取栓术的患者数量，分析机械取栓术数量的机构趋势。为了评估美国机械取栓术数量的现状，评估了 2016 年医疗保险按服务收费数据库中接受机械取栓术的患者数量。分析了进行机械取栓术的各种提供者的专业背景。评估了颅内支架置入术、栓塞术和椎体强化术的手术量。
2013 年至 2017 年，急性缺血性卒中的机械取栓术总数为 2013 年 19 例，2017 年 111 例。2016 年医疗保险按服务收费人群中机械取栓术的总手术量为 7479 例。2015 年美国医疗保险人群中进行了 20850 例颅内血管内手术，2016 年进行了 22511 例。2016 年，放射科医生完成了 45%的手术；神经外科医生完成了 41%；神经内科医生完成了 11%。当结合经皮脑和脊柱手术的总数时，放射科医生完成了 41%；神经外科医生完成了 23%；神经内科医生完成了 3%。2016 年，共有 220 名活跃的 NIR 工作人员在有轮转住院医师或研究员的 NIR 项目中。在这些项目中，49%的工作人员是神经放射科医生，41%是神经外科医生，10%是神经科医生。在有确认轮转研究员或住院医师的 72 个 NIR 部门中，有 14 个部门只有神经放射科医生，6 个部门只有神经外科医生，1 个部门只有神经科医生。
放射科住院医师对 NIR 的兴趣和参与度不断增加，应确保放射科医生源源不断地进入该领域，继续保持放射科在 NIR 领域的参与、领导和创新的强大传统。
